Integration of Buprenorphine/Naloxone Treatment into HIV Clinical Care: Lessons From the BHIVES Collaborative
Integration of Buprenorphine/Naloxone Treatment into HIV Clinical Care: Lessons From the BHIVES Collaborative
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DOI：
10.1097/qai.0b013e31820a8226
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发表时间：
2011-03-01
影响因子：
3.6
通讯作者：
Altice, Frederick L.
中科院分区：
文献类型：
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作者：
Weiss, Linda;Netherland, Julie;Altice, Frederick L.
背景资料：要推广有效的做法，就需要详细说明执行过程、障碍和促进因素以及吸取的经验教训。领导丁丙诺啡艾滋病毒评价和支持倡议的医生的经验提供了宝贵的信息，为其他艾滋病毒提供者寻求整合药物辅助治疗服务到艾滋病毒临床护理。方法：评价工作人员进行了现场访问的10个资助丁丙诺啡艾滋病毒评价和支持计划，以更好地了解丁丙诺啡/纳洛酮（bup/nx）整合的做法;提供的服务;人员配备;提供者对bup/nx的经验和看法;感知的障碍、促进者和可持续性;以及关于复制综合护理计划组成部分的建议。在过去的一年中进行的程序实施现场主要研究人员的采访转录，编码，并根据预先确定的和新出现的themes.Results分析：综合bup/nx和艾滋病毒治疗成功地引入到社区和医院为基础的诊所的传染病，精神病学，和普通内科医生的指导下。除了1名受访的主要研究者外，所有人都对艾滋病毒和bup/nx综合治疗非常满意，所有人都期望继续提供服务。多个处方者是必要的，以确保足够的覆盖面和一个bup/nx协调员（如护士，顾问）被认为是必不可少的提供优质护理。正在进行的挑战包括多物质使用和患者的心理健康问题;同事之间的BUP/NX治疗的有限采用;以及将新的程序，包括尿液毒理学测试到既定的practice.Conclusions的必要性：研究结果表明，综合BUP/NX治疗和艾滋病毒护理是可以接受的供应商和可行的各种实践环境。
Background: Replication of effective practices requires detailed descriptions of implementation processes, barriers and facilitators, and lessons learned. The experiences of physicians leading the Buprenorphine HIV Evaluation and Support initiative provides valuable information for other HIV providers seeking to integrate medication-assisted treatment services into HIV clinical care.Methods: Evaluation staff conduced site visits to the 10 funded Buprenorphine HIV Evaluation and Support programs to better understand buprenorphine/naloxone (bup/nx) integration practices; services offered; staffing; provider experiences with and perceptions of bup/nx; perceived barriers, facilitators, and sustainability; and recommendations regarding replication of integrated care program components. Interviews with site principal investigators conducted during the last year of program implementation were transcribed, coded, and analyzed according to both pre-identified and emerging themes.Results: Integrated bup/nx and HIV treatment was successfully introduced to community and hospital-based clinics under the direction of infectious disease, psychiatry, and general internal medicine physicians. All but 1 of the principal investigators interviewed were highly satisfied with integrated HIV and bup/nx treatment, and all anticipated continued provision of the service. Multiple prescribers were necessary to ensure sufficient coverage and a bup/nx coordinator (eg, nurse, counselor) was seen as essential to the provision of quality care. Ongoing challenges included multisubstance use and mental health issues among patients; limited adoption of bup/nx treatment among colleagues; and the necessity of incorporating new procedures, including urine toxicology testing into established practice.Conclusions: Findings suggest that integrated bup/nx treatment and HIV care is acceptable to providers and feasible in a variety of practice settings.